Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 12 , ISSUE 5 ( September-October, 2020 ) > List of Articles


Perinatal Outcomes among Women with Cholestasis of Pregnancy

Swetha Anand, Naveen Ramesh

Citation Information : Anand S, Ramesh N. Perinatal Outcomes among Women with Cholestasis of Pregnancy. J South Asian Feder Obs Gynae 2020; 12 (5):295-301.

DOI: 10.5005/jp-journals-10006-1827

License: CC BY-NC 4.0

Published Online: 01-03-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Introduction: Intrahepatic cholestasis of pregnancy (ICP), also described as obstetric cholestasis is the second most common cause of icterus in pregnancy. Although not fully understood, proposed theories indicate it could be due to decreased bile flow through the liver and its poor excretion, leading to increased levels of colic and chenodeoxycholic acid. It is known to be associated with adverse maternal and fetal outcomes. Materials and methods: The data were collected by retrospective record review for the past 2 years and the information collected included obstetrical outcomes and complications in mothers with ICP admitted in a tertiary care hospital. Results: Among the 64 pregnant women admitted with ICP, 56.2% of women were booked pregnancies and 47 (73.4%) were in the age groups of 21–30 years. Most women presented with ICP at gestational ages of >37 weeks 51 (79.9%), with the onset of symptom around 33–36 weeks of gestation 21 (32.8%). Common complications encountered were severe preeclampsia and gestational diabetes mellitus 6 (9.3%). Among neonates, meconium-stained liquor (MSL) and low appearance pulse rate grimace activity respiration (APGAR) at 1 minute were common complications. Mothers with ICP were induced with PGE2 (dinoprostone) and 54.7% delivered vaginally. Pregnancies induced with PGE2 and PGE1 (misoprostol) had a higher chance of undergoing lower segment cesarean section (LSCS) 19 (29.6%). Conclusion: Mothers with ICP should be screened antenatally for preeclampsia. The delivery team should be prepared to manage meconium aspiration in the newborn, although most patients deliver vaginally. Key message: Newer modalities of treatment with better pregnancy outcomes in mothers with ICP.

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